In real clinical practice, such methods, and even in combination, are not performed in patients with GERD, therefore, almost all patients with functional heartburn are diagnosed with a non-erosive form of GERD. Data on the prevalence of patients with functional heartburn is clearly overestimated. 10% of all patients visiting a gastroenterologist were obtained only on the basis of the results of daily pH monitoring. Impedancemetry was not carried out by them. We do not know how many of these 10% of patients with heartburn were non-acid reflux patients.
Another interesting possible reason, which was announced only in the last week of American gastroenterology. The Belgian group of Jan Pak, a very well-known specialist in gastroesophageal reflux disease, showed that the clinical symptoms of GERD do not correlate with the parameters of gastroesophageal reflux, but with the presence of anxiety disorders and the degree of somatization. Sometimes it is advisable for patients with persistent heartburn to consult with a psychotherapist.